Management of Depression, Part 1: Identification and Diagnosis

Clinical depression is a commonly occurring and profoundly disabling condition that affects approximately 4%, or nearly 350 million people, worldwide. Depression has been identified as the world’s leading cause of disability and a major contributor to overall global burden of disease. In the United States alone, estimates of economic burden are greater than 200 billion dollars, including costs of direct medical care, suicide-related mortality, and lost work productivity. Managing depression is challenging due to the marked variability in biological contributors, the heterogeneity of the illness, psychosocial history, current stresses exacerbating the condition, medical and psychiatric co-occurring conditions, lifestyle, and motivation and willingness to accept and engage in treatment recommendations. This review discusses diagnosis, depression screening and workup, neuroimaging, differentiation among depression types, patient safety, and treatment initiation in patients with depression. Tables list DSM-5 versus ICD-10 classification of depression and DSM-5 updates with respect to depression.   This review contains 5 tables and 60 references Key words: bipolar depression, clinical d